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Whistleblower Report

Use this form if you have information about behavior that may impact community safety but did not occur in your presence or did not involve you directly.

Click the button below to begin the report.

Start

Question 1 of 9

Please provide your name

Note: This will be kept confidential

Question 2 of 9

Please enter your email address

Used for confirmation and follow-up only

 

Question 3 of 9

What best describes the information you are reporting?

A

Information shared with me by someone else

B

Prior behavior in another community or context

C

Ongoing concern that may affect safety at Haüs of Bliss events

D

Other

Question 4 of 9

Does this concern relate to someone who is currently a member or attendee?

A

Yes

B

No

C

Possibly/ Not Sure

Question 5 of 9

What is the information you are sharing

 

Focus on what you were told or what you are aware of.
You do not need to speculate or draw conclusions.

Question 6 of 9

How do you intend for this information to be used?

A

For leadership knowledge only

B

For a potential escalation to incident

Question 7 of 9

I understand that...

A

this information may be used to assess patterns or prevent harm

Question 8 of 9

I understand that...

A

this form does not automatically trigger an incident workflow or disciplinary action

Question 9 of 9

I understand that...

A

escalation to an incident does not *guarantee* an incident workflow should the impacted parties not desire to file

Confirm and Submit